Your Health

The herb Tribulus terrestris, left, stimulates the brain, leading the body to produce more lutenizing hormone in men.

The term used to describe declining testosterone levels in men as they age – “andropause” – is not really the same thing as menopause in women. That’s because the decline in male hormones happens over a longer period of time.

According to the Mayo Clinic, “Testosterone levels gradually decline throughout adulthood – about 1 percent a year after age 30 on average.” It’s estimated that as many as 5 million men per year suffer from low testosterone levels.

The role of testosterone

Among other functions, testosterone is a stress-handling hormone in men. It makes men feel more vital and plays a number of other critical roles, including sperm production, achieving and maintaining erections, and supporting liver function, bone formation and blood cell production.

Symptoms of low testosterone include:

• Decreased muscle mass

• Reduced endurance

• Decreased libido

• Insomnia

• Nervousness and depression

• Hair loss

Excess levels of testosterone can lead to an overgrowth of the prostate gland and aggressive behavior.

Forming an action plan

If you think you have low testosterone, it’s important to verify the diagnosis. Because many conditions can mimic symptoms of testosterone deficiency, you’ll want to rule out other causes of your symptoms. Your doctor can advise you on the best plan of action.

In my office, I make recommendations based on the severity of symptoms and often order a comprehensive male hormone panel to get a clear picture. In addition to assessing levels of testosterone, it’s important to understand what’s happening with other hormones like DHEA, progesterone and androstenodione.

Hormone testing

Male hormone levels can be measured easily via blood or saliva tests, but saliva tests are superior in their ability to measure active hormone levels in the body. Hormones in the blood are largely inactive because they are bound to proteins. Blood hormone levels must then be extrapolated to calculate active levels of a given hormone.

Testosterone delivery methods

Although many forms of testosterone supplementation exist, transdermal gels seem to be the most efficient delivery method. The downside is that the cost of this method is higher than others. If you think you have low testosterone, consult with a urologist or primary-care physician for more information and recommendations.

Tribulus: An herbal alternative

In my practice, I use an herb called Tribulus terrestris. As far as I know, the only legitimate species comes from Bulgaria, and the active ingredients come only from the aerial parts of the plant (leaves and stems). This limited availability has led to a multitude of fakes on the market, which are often made of different species or from the root.

Tribulus is thought to work by stimulating androgen receptors in the brain, which in turn tell the pituitary gland to produce more lutenizing hormone (LH) in men. LH stimulates cells in the testes to produce testosterone. Just as with medications, herbs like tribulus should be taken under the care of an herbalist or qualified physician. Men with prostate problems should use Tribulus with caution.

Supplementation risks

Hormone production in the body is a highly sophisticated process and supplementing can have unintended results. In some cases, supplementing with testosterone can lead to elevated levels of estrogen. This occurs when aromatase – an enzyme found in fat cells – converts testosterone to estrogen. It stands to reason that overweight men are at greater risk for this to occur.

In addition, testosterone may be converted to another male hormone: Dihydrotestosterone (DHT). Elevated levels of DHT are associated with excess prostate growth.

Balance is key

Active hormones in the body are so potent that they are measured in parts per million and sometimes parts per billion. Supplementing with an active hormone – one that can be used immediately by the body – can be risky business. Any hormone supplementation program should be accompanied by active monitoring of hormone levels in the saliva (ideal) or blood.

I suggest a three-month interval between testing along with monthly evaluation of symptoms. An even better scenario would be to have a baseline measure of hormone levels before any symptoms occur. It may also be prudent for the prostate to be assessed in advance of any hormone supplementation.

Ted Ray is a licensed acupuncturist and herbalist in private practice in Mountain View. For more information, call 564-9002 or visit www.peninsulaacupuncture.com.

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